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Thursday, October 2, 2008

My Grass Has Always Been Green

How do you keep going with a juggling act after losing one hand? I am a doctor married to a doctor. I am fortunate to possess the holy grail of mothers in medicine: a part-time job that is (mostly) really part-time. Somehow though, much like getting a raise and then finding yourself saving no more money than you used to a few months down the road, I have the same issue with time. The extra TWO FULL WEEKDAYS OFF per week I reveled in two years ago have somehow become the new norm, and we are again wishing for more hours in the day, more days in the week. Somehow my daydream that the busy work of our three small kids--the doctor’s appointments, grocery shopping, haircuts, laundry, trips to return library books, etc--would be accomplished in those two days with hours of quality time to spare, leaving evenings and weekends for nonstop family fun, was popped in a matter of months. We are in no better shape than we were before. We feel like we are just barely keeping our heads above water again.

So, picture the scene. It’s Wednesday, my late day in clinic. I get home at 7:15pm. Bedtime is officially at 7:30pm. The kitchen looks like a still shot from Storm Stories. No one is in the tub yet. A quick survey of the kids’ bedrooms alone foretells at least an hour of “pre-cleaning” for our once-a-week housekeeper visit. I breastfeed “Fig,” our 7 month old, on my lap while attempting to eat a petrified bagel that I actually toasted YESTERDAY morning and never managed to get out of the toaster because at least, it’s ready to eat, lunging simultaneously for 4 year old “Munch” who is begging to be tickled over and over in the next seat, all while nodding and listening to precocious not-yet-3 “Iggy” describing random events of her day in what has to be the world’s longest run-on sentence ever, except this one. Everyone eventually gets washed, combed, toothbrushed, pajamed, read to, and tucked in. The house is returned to some semblance of order. Finally, after 2 ½ hours of the parental version of running uphill on a treadmill backwards, it’s 9:45pm and we collapse in bed to say hello to each other for the first time. Then my hubby drops the bomb. “The Comfort is leaving on Sunday.” The Comfort is the Navy’s hospital ship. I am too tired to wonder why this would be the first thing out of his mouth when we haven’t seen each other all day. “Oh really?” I say. “This Sunday,” he adds hesitantly. “Wow, where are they going?” “Georgia…ex-Soviet Georgia.” “That’s really short notice,” I note with vague disinterest. At this point, he obviously can’t take my dementia of exhaustion another minute and says, “I’m on it.” “WHAT?!?!?!”

And, in that moment, the juggler lost her left hand in mid-act. Suddenly I had 72 hours to figure out how to swing being both the “drop-off” and the “pick-up” parent, who was going to get my son to his weekly PT appointments which were right in the middle of my late afternoon clinic, how I could even register our kids for the preschool they have been so excited to restart which required being in line outside the school by 5:30 am the day after he was leaving, what I would do if we had a childcare crisis since I had just used up every iota of my vacation and sick leave and then some from taking 4 months of maternity leave, and on and on. My mind raced. The list grew. The punctuation vanished.

Ok, I told myself, you can do this. You have done this before. He had been deployed for 19 weeks while I was pregnant with our third child, just gotten back only 10 months prior in fact. We already knew he would be deployed again in April 2009. But for those, we had time to prepare ourselves and the kids, time to make arrangements, time to exhale and come to terms with it. This time, it came out of nowhere. Well, it wasn’t entirely out of nowhere. There was a moment, I think, during my commute two days prior when I heard on NPR that Russia had just bombed Georgia, a fleeting moment when I thought to myself: “Uh-oh”. But I put it out of my head, reasoning that we couldn’t be in Iraq AND Afghanistan AND Georgia. Our military was stretched too thin as it was. And there was an election in a matter of months. No, nothing to worry about.

The next week after that Wednesday night bombshell went by in a blur as I attempted to cancel and reschedule our lives, make contingency plans, prepare the kids emotionally when I wasn’t even prepared myself. The miraculous news that the entire US deployment to Georgia would be canceled came several days later, not from the US Navy, but rather from a Baltimore Sun reporter and new personal hero named David Wood. That is a saga in and of itself for those who are interested: http://weblogs.baltimoresun.com/news/militarywatch/2008/08/post_45.html. But this is one long preamble for the real topic of this blog.

The next woman I saw in clinic was a new patient, 34 years old, a mother of 4 kids ranging in age from 1-7, widely metastatic breast cancer, a recent move from out of state for her husband’s high-travel job, no immediate family on either side, and no friends to speak of yet for 800 miles in any direction. She reported in a perfectly matter-of-fact way when I asked about her meds that she takes an extra dose or two of Oxycodone to control her bony pain enough to be able to make the kids dinner and do their baths. I was paralyzed by awe, by shame, and by the perfect storm of awe and shame: humility. As I sat wringing my hands over my husband’s unexpected, uncertain, and slightly risky deployment of probably a few months—maybe six at most—here sat this woman in constant pain, facing her own certain mortality, juggling despite having lost both arms, knowing that if she even blinked or faltered ever so briefly, it was over. Permanently. And her husband. What would he do? When she was gone, he would be on his own until the last baby was grown. And he worked full-time. Traveled several days a week. Seventeen years. It was an eternity. It was incomprehensible to me. How would he ever manage? How did he even lift his head off the pillow every morning? Here sat this young couple in front of me, and I was supposed to be the wise one? The doctor? And, in that moment, I became a medical student again. Suddenly I was the same young woman who years ago stared wide-eyed as patients gave their spouses a last kiss before being wheeled in for their liver transplants, wondering if they would make it, wondering how they managed to smile, wondering how they could be so strong, wondering whether I could ever be so strong, hearing that disquieting voice that told me I knew the answer and it was no.

It’s been over 6 weeks since this all happened, but I am think I am permanently that medical student again, if a bit more wrinkled these days. I realize now that every patient I see is living some variation of this story. She is trying to get her chemo and get home after dropping off her son at preschool and before her daughter gets off the bus and hoping her nausea medicines will work well enough that evening for her to cook dinner without the smells making her sick. She is terminally ill and desperately wants more time at home but cannot quit her full-time job because, without it, she will lose her health benefits and therefore, the treatment that may give her another month or two with her children. These people are all juggling more than I could ever comprehend and with so much more at stake.

I finally got it. After so many years focusing on whether the grass was greener on the other side, I finally realized that my grass has always been green. I just never sat still before long enough to notice.

15 comments:

I find it so helpful to read posts like this, because it is so easy to forget how good we actually have it. Even after working in an inner city clinic and working in a clinic in Africa, I am amazed that I can still get caught up in my small problems and forget how truly lucky I am.

I work as a research assistant in a heme malignancy program while trying to get into med school. I always find that the day I'm complaining about anything and everything is the day that we discuss a 20-something year old person, just like me, who has just been diagnosed with leukemia and is fighting for their life. It really puts things in perspective and is great at making you humble.

Also, I have been reading this blog for a while and really am loving it. I was raised by a mom in medicine and hopefully will one day be the same.

I honor you, Tempeh, for your wisdom, strength and story telling. We must all be conscious of the stresses and challenges that others face with such grace. Wonderful reminder that I'll carry through my day.

Thank you for this eloquent example of the patients who make us remember exactly why we wanted to be physicians in the first place - I think we'd all bend over backward for this woman, despite our own problems. And thanks for reminding us that no matter how frustrating our day is, there's always someone who is worse off.

And I'm glad that hubby is going to be around - even if for only a few more months.

You touched on one of the main reasons I decided to come to medical school rather than just get a PhD. The patients remind us how lucky we are to have the lives we have, and we are in a position to provide meaningful help to them.

Mothers in Medicine is a group blog by physician-mothers, writing about the unique challenges and joys of tending to two distinct patient populations, both of whom can be quite demanding. We are on call every. single. day.

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